Radiofrequency ablation for the treatment of paroxysmal atrial fibrillation in complicated cases / 中国介入心脏病学杂志

ABSTRACT

Objective This study was aimed to investigate the methodology of radiofrequency ablation for paroxysmal atrial fibrillation (PAF) in complicated cases Methods 130 cases (87 males) with the average age of 56 years were enrolled consecutively Each patient was diagnosed PAF by Holter and ECG After routine transseptal procedure and cannulation, retrograde pulmonary venography was taken to show the anatomic morphology of all pulmonary veins (PVs) Under the guidance of Lasso circular mapping catheter, all cases underwent electrical isolation for four PVs using the saline irrigated ablation catheter Results (1) By venography,21 PVs (16 2%) were found to have enormously dilated ostia in 21 out of 130 cases 5 PVs (3 8%) had left common trunks 3 PVs (2 3%) had right common trunks In 6 cases right PVs were found to have multiple bifurcated ostia, and the prevalence rate was 4 7% (2) A total of 341 PVs were targeted for segmental ablation in 130 cases Complete isolation was failed in 29 PVs, including 11 PVs with dilated ostia Among the 29 PVs, 14 were left superior PVs (LSPVs), 8 were left inferior PVs (LIPVs), 5 were right inferior PVs (RIPVs), and 2 were right superior PVs (RSPVs) Conclusion The anatomical variants of PV was the main cause of complicating radiofrequency ablation in patients with PAF